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Beyond Repeal: If Obamacare Survives, It Must Be Fixed

This National Journal piece, titled “The Secret Republican Plan to Repeal ‘Obamacare’,” has come in for a fair amount of mocking on the right. The “secret plan” turns out to be the GOP leadership’s very public, well-known, high-profile desire to … vote to repeal Obamacare. Just last week the GOP put up yet another (failed) amendment to repeal the health care reform law.

If the Republican Party is trying to keep its plan to repeal Obamacare a secret, it isn’t succeeding. The political press has been unable to conceal its annoyance at the GOP’s stubborn fight to rid the country of an unpopular law. Conservatives are, appropriately, unfazed by the president’s palace guard in the media doing their best to dictate the policy agenda. The left says the fight is over, and Obamacare is here to stay. But if that’s true, they’re only half right: if Obamacare is here to stay, the fight is only beginning. The law is so shoddy and onerous that it is going to take sustained effort for lawmakers to fix the worst parts of the bill just to make it workable. Obamacare is unsustainable as-is.

It won’t lower insurance costs. It also won’t achieve universal coverage. It is designed to kick millions of Americans off insurance plans they are satisfied with and they can afford. It will depress wages and full-time employment. It forces religious institutions to violate their faith by removing the separation of church and state and defining Catholic practice outside the bounds of law in the age of Obamacare. It is, in almost every way, a colossal failure of governance and reveals as fiction the left’s self-identification as an intellectual, fact-driven political movement.

But it also has to be fixed. Conservatives will not be satisfied for the law to stand as a monument to liberalism’s inability to govern, because the American people rightly have no interest in being Democrats’ lab rats. That’s why the GOP keeps trying to repeal the law, but it’s also why, absent repeal, the fight over Obamacare will continue for years to come. It creates too many problems to be left alone. As Shikha Dalmia writes at the Washington Examiner:

The Iraq War cost $1 trillion and produced a quagmire abroad. Obamacare will cost $1 trillion and will create a quagmire at home. Americans need an exit strategy.

I don’t endorse the comparison of any domestic policy law to the horrors of war, but Dalmia’s framing of the issue is more useful than the simplistic repeal/don’t repeal argument the two sides have conducted for three years now. Republicans lost an opportunity to repeal the law when they failed to take the Senate and White House in November. They will, however, have the support of some Democrats to help alleviate the burden Obamacare has forced onto the American public.

One example is the law’s medical device tax, which will hurt medical innovation and cost jobs. The Senate passed a nonbinding, symbolic expression of repeal this past week with 79 votes in favor of getting rid of the excise tax. Obamacare’s discriminatory contraception mandate was, according to Democrats, “un-American,” “a bad decision,” “a violation of conscience rights,” among other critiques of the policy.

Those are only some of the battles in Obamacare’s future, since those parts of the law are so obviously harmful that even Democrats—now that they’ve found out what was in the law they voted for—would support eliminating them. But the rest of the bill is more complex. Douglas Holtz-Eakin and Avik Roy penned an op-ed last month explaining how to use Obamacare to fix Obamacare—in part by utilizing the insurance exchanges to open the system up to more traditional market pressures. Such ideas require an acceptance that Obamacare won’t be repealed. But their support among politicians, and not just think-tankers, also indicates that conservatives are getting serious about health care reform in a way they weren’t before Obamacare captured the debate.

It’s a shame it took the Obamacare monstrosity to focus congressional Republicans’ attention on health care. But it’s encouraging that the debate over repeal is the beginning, not the end, of the political class’s efforts to correct the Obama administration’s mistakes.


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